Endoscopes are known in the art for, inter alia, providing lighting and lens systems for visual examination of the interior of a body organ or cavity. Such devices are also used in otolaryngology, and allow viewing of the nasal passages, paranasal sinuses, base of the skull and the like while simultaneously providing for delivery of pressurized fluids for flushing and removal of nasal tissue, as well as secretions and discharge. An unobstructed view of the deep cavities which can be brought about by the pressurized-washing of occluding tissues, is as important as a precise surgical technique. Reference may be had in this regard to Federal Republic of Germany Patent 3803212, the text and teachings of which are hereby incorporated by reference as if set forth completely and at length, herein.
However, such devices do not allow the aiming of the fluidized discharge within the focal plane or focused field of view of the endoscope. Such a modified endoscopic instrument would improve many nasal surgical applications and treatments by allowing accurate targeting of the fluid followed by confirmation by simultaneous visualization that the fluid has impacted the target, including, e.g., for nasal polyps, tumors (including angiofibromas), mucocele or mucopyocele of the sinus, removal of nasal foreign bodies, as well as in treatment of sinusitis (ethmoidal, sphenoidal or frontal), folliculitis, and epistaxis.
Known surgical methods, like the Caldwell-Luc method for nasal polypectomy, require invasive surgical technique and are performed without tools to effectively enable the directionable washing or non-invasive removal of tissue, with visual confirmation and supervision made available to the surgeon. Likewise, cauterization to control bleeding in, e.g., Kiesslbach's area is often preceeded by the dispensation of a mild vasoconstrictor (e.g., phenylephrine), typically via a soaked cotton pressure pack, which generally dispenses the drug to a region, without simple ability to determine whether the target has successfully been reached.
Accordingly, it is an object of the present invention to provide an endoscope capable of visualization and targeting of, among other things, an otolaryngological site, followed by washing and removal of tissue (coagulated or otherwise) and, if necessary, application of other fluidized materials like, e.g., pharmaceuticals (including, e.g., phenylephrine followed by silver nitrate, chromic acid bead or other cauterization drugs).
It is yet another object of the present invention to provide a device for washing and suction while providing simultaneous observation of tissue through an optical system, and the loosening and/or removal of tissue, secretions or encrustations for use in nasal surgery.
It is still a further object of the present invention to provide the targeting of key otolarynogological areas and the presentation of fluids at the targeted areas with visual confirmation that the areas have been hit, and that the objective (e.g., removal of tissue, presentation of drugs, etc.) has been achieved without the need to resort to more invasive surgical techniques.
It is a yet further object of the present invention to provide a means and method for viewing deep cavities by stripping away view-occluding tissues through pressurized-fluid jetted at the location, followed by aspiration or other suction, all performed while simultaneously viewing the targetted operation site.